Provider Demographics
NPI:1164418083
Name:NOBLE, CATHERINE EVELYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:EVELYN
Last Name:NOBLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 BIEHN ST
Mailing Address - Street 2:STE 3
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1181
Mailing Address - Country:US
Mailing Address - Phone:541-884-3148
Mailing Address - Fax:541-884-3373
Practice Address - Street 1:2613 ALMOND ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1116
Practice Address - Country:US
Practice Address - Phone:541-887-8229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR170061Medicaid
ORMN0136196OtherDEA
ORMN0136196OtherDEA
OR170061Medicaid